RN Intake Coordinator II - FT Days

Torrance Memorial Medical Center • Torrance, CA

38d • $47 - $78

About The Position

Responsible for the intake of new and complex referrals to home health and hospice and coordinating services for referred patients

Requirements

• College Diploma in Nursing
• 3 years of Healthcare managed care, home health agency or case management experience

Responsibilities

• Accepts referrals from hospitals, physician offices, SNFs and other community referral sources, obtains required orders for services and coordinates infusion products and DME/HME delivery
• Pre-screens clients referred by physicians for hospice needs, eligibility, and homebound status, if appropriate
• Evaluates patients referred to the Organization; identifies insurance coverage, negotiates payment or per diem rates; plans and coordinates referrals for hospice services.
• Collaborates with the case manager to expedite discharges and screen admission requests..
• Triages the needs of referred patients to assist scheduling for same day or within 48 hours of referral
• Elevates issues as appropriate to the Director, Revenue Cycle.
• Responds to voicemail and emails within 24 hours of receipt. Forwards patient complaints to the Lead Patient Account Representative or Director, Revenue Cycle, when appropriate.
• Stays informed of updated insurance requirements and reimbursement practices
• Maintains an advanced knowledge of insurance payor contracting as well as authorization requirements by payor.
• Maintains knowledge of the methods of payment, pricing and insurance billing.
• Maintains comprehensive working knowledge of managed care contractual relationships and ensures that patients are admitted and services are delivered in accordance with contract provisions.
• Develops and maintains cooperative relationships with hospital personnel, physicians, suppliers and insurance case managers.
• Arranges for alternate hospice providers utilizing Letter of Agreement for capitated patients out of the service area.
• Sets realistic expectations with patients/families regarding hospice service

What This Job Offers

• Job Type: Full-time
• Education Level: Associate degree
• Number of Employees: 1,001-5,000 employees